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General NPI Number Information
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NPI Number | 1184931792
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Entity Type | Individual
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Provider Name | AMY DANIA MASON LMT
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Gender | Female
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 29 CLINTON ST
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City | BROCKPORT
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State | NY
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Zip | 14420-1803
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Country | US
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Telephone | 585-637-3126
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Fax | 585-637-3126
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Provider Business Mailing Address
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Address Line | 384 DRAKE RD
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City | HAMLIN
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State | NY
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Zip | 14464-9525
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Country | US
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Telephone | 585-729-4662
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Fax | 585-637-3126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 017733-1
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License Number State | NY
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